Rectus Fascial Sling
This well established technique uses your own body tissues to recreate lost urethral support and unlike TVT does not use any synthetic mesh.
Also known as Pubovaginal Sling or Autologous Sling.
Who is a Rectus Fascial Sling procedure best for?
Most women with stress incontinence will be suitable for a Rectus Fascial Sling. Ladies who are concerned about the small risks associated with TVT synthetic mesh (for example - mesh erosion) can choose to have a Rectus Fascial Sling. The rectus fascial sling procedure is especially useful for treating ladies who have had failed prior incontinence procedures, sphincter weakness incontinence or mesh related complications.
How is the procedure performed?
The rectus fascia is the thin but very tough layer that covers the abdominal muscles. Through a small incision just below the bikini line a strip of the rectus fascia is removed - this is then placed under the urethra as a supportive sling. The inside of the bladder is always checked after TVT insertion by cystoscopy to ensure correct and safe tape position. The small incisions are closed using dissolving stitches. A catheter is placed during the surgery which is removed the following day. Patients can go home on the first day after surgery and return to work and non-strenuous activity after one week. Sexual intercourse is comfortable after 4-6 weeks. Heavy lifting and strenuous activity is best avoided for three months.
What are the risks?
Occasional adverse effects can occur after rectus fascial sling surgery - 1 in 10 ladies may have short term difficulty urinating or may develop overactive bladder symptoms. Much rarer complications are bladder or injury or significant bleeding.
As the rectus fascial sling is your own bodies tissue there is absolutely no risk of mesh related problems such as chronic pain, infection, urethral and bladder erosion that can occasionally be seen after synthetic TVT type procedures.
How effective is the procedure?
We believe that long term patient satisfaction is the most important goal when performing surgery for urinary incontinence. Five to seven years after surgery the majority of ladies remain continent and satisfied with the results of this type of surgery.